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Dec 14, 2012
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there are a few problems in pennsylvania created by the aca. the law mandates that we expand our provider enrollment system to check with their medicare data. medicare databases cannot handle automated changes. we will have to add staff resources to respond to 100,000 inquiries every month. we are mandated to create separate databases to accommodate is exchanges and some databases like the masterfile, we have not been given access to. we adopt past medicaid rules radically changing the tailor- made renewal system that took years to refine and perfect. the verification system will not be coordinated with other welfare programs creating eligibility verification issues. the mandate says we use the correct coding issues. pennsylvania already performed this task through claim check, a federally approved system that cost pennsylvania $12 million to develop. the new system will be micromanaged by the federal government. the ac man it's we create new transaction methods for verification. our technology is more advanced than what is mandated and nobody
there are a few problems in pennsylvania created by the aca. the law mandates that we expand our provider enrollment system to check with their medicare data. medicare databases cannot handle automated changes. we will have to add staff resources to respond to 100,000 inquiries every month. we are mandated to create separate databases to accommodate is exchanges and some databases like the masterfile, we have not been given access to. we adopt past medicaid rules radically changing the tailor-...
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Dec 14, 2012
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regarding health care quality for exchanges on november the 27, it specifically mentions a section, 1311 of aca, which directs quality health plan issues and improvement strategies as directed by the secretary, specifically subsection 8 of 1311 would allow the secretary to prevent physicians treating patients in exchanges unless they implement such mechanisms to improve health care quality the secretary may require. physicians must follow quality directives as defined by the secretary or lose their business. mr. smith, are you aware of this provision? >> i am not familiar with that section. >> let me ask you this. in this provision, you may not know this either, but the word quality is not defined in the statute. it is safe to assume that the secretary, not just secretary sebelius, but every secretary to follow, would be able to define for regulation what that word quality means. yes or no? >> i believe that is the correct interpretation. again, we have tried to introduce quality performances into a variety of parts of our programs, both in managed care, both in the fee-for-service world, and t
regarding health care quality for exchanges on november the 27, it specifically mentions a section, 1311 of aca, which directs quality health plan issues and improvement strategies as directed by the secretary, specifically subsection 8 of 1311 would allow the secretary to prevent physicians treating patients in exchanges unless they implement such mechanisms to improve health care quality the secretary may require. physicians must follow quality directives as defined by the secretary or lose...
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Dec 14, 2012
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the aca contends cost- containment measures by improving care. i was interested in arkansas's payment reform efforts. could you tell us a little bit more about the payment reforms and how they would bring down costs? >> we believe the in arkansas the incentives that we face and the activities we are engaged in in our payment and improvement initiative are aligned with the center for medicare and medicaid innovations. we are engaged in moving away from a fee for service to pay for out comes a denture health care instead of the process that we currently paid for. -- outcomes of in health care instead of the process we currently pay for. we are looking for patience centered care. if we look for that, we are going to have to pay for it. we have not done that in the past. we are engaged and dramatic and sweeping changes working with our private health insurance partners in arkansas. we have worked closely with cms to make the first of these changes, implementing in october for the state plan, not through waiver. it incentivizes for adhd, perinatal car
the aca contends cost- containment measures by improving care. i was interested in arkansas's payment reform efforts. could you tell us a little bit more about the payment reforms and how they would bring down costs? >> we believe the in arkansas the incentives that we face and the activities we are engaged in in our payment and improvement initiative are aligned with the center for medicare and medicaid innovations. we are engaged in moving away from a fee for service to pay for out...
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Dec 11, 2012
12/12
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aca is implemented, it will be felt in states that have not implemented exchanges. we hear every day how much health care costs are effecting business decisions. we are trying to make sure that input from companies like yours gets to washington and washington reacts. host: atlanta, georgia. independent caller. caller: my first observation is i thought you said your organization predated the obama administration. guest: the reference to the word "forward" and how do you obama administration used in the campaign, but we have been named in 2009. host: he was saying before the reelection campaign. caller: the small business groups you represent, where their feelings about tax reform, and specifically what they support a national sales tax? i supported in gary johnson. regarding the affordable care act, will your membership consider abandoning -- providing health care or health insurance for employees and letting them deal with these exchanges in order to save money? my understanding is the affordable care act is onerous on small business. thank you. guest: . right. just
aca is implemented, it will be felt in states that have not implemented exchanges. we hear every day how much health care costs are effecting business decisions. we are trying to make sure that input from companies like yours gets to washington and washington reacts. host: atlanta, georgia. independent caller. caller: my first observation is i thought you said your organization predated the obama administration. guest: the reference to the word "forward" and how do you obama...
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Dec 29, 2012
12/12
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intermediate deficit problem and implementation of the cost saving measures strengthened over time in the aca will deal with their long-term health care problem. so we are not that far away and we have other tremendous strengths in our country that would allow us to make the kind of investment to transform the economy, to do with the reality of stagnant wages and a sense of diminished opportunities. we have strengths. we can do it. we need the public to rain and behavior that's destructive and we need political leaders to act forcefully. given enough to bipartisan commissions and searched enough for bipartisan consensus. for sensible hard all politics along these lines. >> norm, i particularly cutie take the money question. a couple political had a great shared that showed that party polarization in congress was directly correlated with increasing concentrations of wealth from increasing equality went together artisan polarization. and the money question you can handle so many different ways. i'm really concerned about it posed citizens united system with a federal election commission that's
intermediate deficit problem and implementation of the cost saving measures strengthened over time in the aca will deal with their long-term health care problem. so we are not that far away and we have other tremendous strengths in our country that would allow us to make the kind of investment to transform the economy, to do with the reality of stagnant wages and a sense of diminished opportunities. we have strengths. we can do it. we need the public to rain and behavior that's destructive and...
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Dec 11, 2012
12/12
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in terms of health care costs related to the aca, while most business leaders that we have spoken to have said is they understand we needed to do something. small-business owners are impacted disproportionately by rising health-care costs. the current health care plans work for them less well than they do for larger companies because they don't have buying power. if you look at some of the reforms, you see a number of efforts to try to reduce costs for small businesses to, like creating exchanges, for example. small in 2011, small businesses paid 25% more for insurance than large companies. the exchange is meant to help small business. you are right. with the new regulations set to take effect in a couple of years, it is another reason to be careful and protect small businesses from tax increases. what the obama people will tell you is that they have cut taxes for small business 17 times and 90% of the small businesses in america would not be effected by higher individual taxes. host: here is "the miami herald" this morning. pennsylvania. independent caller. caller: he said it earlie
in terms of health care costs related to the aca, while most business leaders that we have spoken to have said is they understand we needed to do something. small-business owners are impacted disproportionately by rising health-care costs. the current health care plans work for them less well than they do for larger companies because they don't have buying power. if you look at some of the reforms, you see a number of efforts to try to reduce costs for small businesses to, like creating...